Home       Basketball Coaches Without Boundaries 

A New Generation of Coaches for the next Generation of Student Athletes

Fall Basketball League

September 10th through October 29th 

Team Registration Form - Without Practice

Please Print this Form and Mail to: BCWB, P. O. Box 3528, Frederick, Md 21705

 

Team Name          

Head Coach Name    Assistant Head Coach Name   

City, State and Zip   

Home Phone              Cell Phone

Email Address            

Team Grade    3rd/ 4th  5th/ 6th  7th/ 8th  9th/ 10th  11th/ 12th

 

Boys  League    Girls  League 

Team Talent Level   Beginner    Intermediate      Advanced 

Sending Roster as an email attachment

Player Information

Jersey 

#

First Name Last Name Height T-Shirt Size DOB Grade School

 

No Refunds after:     August 1, 2016  

 

Medical Release & Registration Agreement  

The undersigned, parent/legal guardian of the player requesting league admittance, does hereby affirm that the applicant is in good health and suffers from no illness, disability, or condition that requires the taking of medication on regular basis unless that condition is disclosed and approved. Furthermore, the undersigned has no knowledge of any reason the applicant cannot participate in vigorous physical activity. The undersigned hereby expressly agrees to be responsible for any medical bills incurred in the treatment of any illness or accident. In the event of any such accident or injury, I hereby consent to allowing any of the league supervisors to procure any medical treatment deemed advisable on behalf of my child or ward without prior consent. I understand that, as a condition of admittance as a league participant, the undersigned, on behalf of all parents and guardians, and behalf of the applicant, hereby release Basketball Coaches Without Boundaries and all other employees or agents of the league from any and all liability in regards to injury or illness, either mental or physical suffered by the league participant during or related to the league by the person or entity against which the claim is made.  

 

Signature __________________________________________________________  Date _______________________________________

 

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